Impact of recurrent urinary tract infections on women

BACKGROUND: Many women experience recurrent urinary tract infections (rUTIs) yet their significance for the women affected is poorly described and understood. AIM: To explore women's experiences of rUTIs and the impact on their lives. DESIGN AND SETTING: A qualitative study embedded in a randomised controlled trial (RCT) of D-mannose with women with clinically defined rUTIs in England and Wales. METHOD: We conducted semi-structured telephone interviews with 32 women who participated in the RCT. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically. RESULTS: Women reported how the experience of rUTIs was burdensome with distressing and debilitating physical symptoms and wider disruptive effects. Women expressed how rUTIs had an impact on different stages of their lives and we identified two types of impact. Internalised impact included the women's emotional response to rUTIs, dread of a recurrence, and maintaining readiness to manage it. Externalised impact encompassed actions in response to rUTIs, including remaining extremely vigilant about recurrences and seeking help as soon as a recurrence was suspected, and the challenges they faced. The women explained how the responses of healthcare professionals (HCPs) when they sought care affected their help-seeking and their self-esteem, and could leave them with a sense of helplessness. CONCLUSION: Experience of rUTIs has taught women to be vigilant and proactive about the condition but this was not always matched with understanding and validation on the part of HCPs. When women experiencing rUTIs seek care, clinicians could usefully consider the patient's broader experience of rUTIs, including internalised and externalised impacts.